Health Care Hiring, Medical Jobs
Search from millions of jobs nationwide
Find health care employers in your area
NPI Search for Physicians and Health Care Providers
KERISA SUE ELLOWAY D.D.S.
Pediatric Dentistry >> Dentist >> Dental ProvidersRegistrant NPI Number: 1154452324
Individual Registrant: KERISA SUE ELLOWAY D.D.S.
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
1730 MAIN ST SUITE A FORTUNA, CA 95540-2451 US
Tel: 707-725-1303 Fax: 707-725-1358
Tel: 707-725-1303 Fax: 707-725-1358
Contact information for business:
1730 MAIN ST STE A FORTUNA, CA 95540-2451 US
Tel: 707-725-1303 Fax: 707-725-1358
Tel: 707-725-1303 Fax: 707-725-1358
Registration Information:
NPI: 1154452324
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223P0221X | Dental Providers Dentist Pediatric Dentistry | CA | 47254 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
